Spontaneous cholesteatoma of the external auditory canal: the utility of CT.

Spontaneous external auditory canal (EAC) cholesteatoma is a rare disease. The symptoms are nonspecific. It is diagnosed by clinical examination and radiological investigation. The clinical examination alone is often insufficient for accurately assessing spread of the cholesteatoma into the temporal bone, meaning cross-sectional imaging modalities are required, and specifically computed tomography. We report three cases of spontaneous cholesteatoma of the external auditory canal. All of our patients underwent surgery. In two cases, the cholesteatoma was restricted to the external auditory canal, while in one case, it was complicated by a fistula with the lateral semicircular canal. Good anatomical and functional results were obtained in all three cases, with the external auditory canal patent and a good calibre on completion.

[Congenital cholesteatoma in children]. / Cholestéatome congéntial.

OBJECTIVES: To report on two cases of congenital cholesteatoma in patients aged 1 month. To review the clinical and radiological features of congenital cholesteatoma and to clarify the contribution of the CT scan in the diagnosis and the preoperative workup. PATIENTS AND METHODS: The authors report two observations of congenital cholesteatoma. These children were investigated using high-resolution CT. The treatment was surgical in both cases. RESULTS: The children were 1 month old, presenting with facial paralysis. In the otoscopic exam, the tympanic membrane was normal in both cases, with a whitish retrotympanic soft mass. The diagnosis of congenital cholesteatoma was made based on the CT data. CONCLUSION: Congenital cholesteatoma is rare. Otoscopic examination must be undertaken during the physical exam of a child at a young age to establish an early diagnosis. CT scan allows positive diagnosis and a precise preoperative workup.

Primary hydatid disease of the thigh. A rare location.

Primary muscle hydatidosis is very rare, accounting for less than 1% of hydatid cyst locations. Clinical symptoms are insidious and non-specific causing a frequent delay in diagnosis. Intramuscular hydatid disease can cause a variety of diagnostic problems, especially in the absence of typical radiologic findings. We report the observation of an 82-year-old man consulting for inguinal tumefaction with radiological exploration suggestive of hydatid cyst of the adductors muscles. Magnetic resonance imaging (MRI) is helpful in diagnosis, since it reveals a very suggestive aspect and demonstrates the relationship between cysts and adjacent structures. Treatment of muscle echinococcosis is based on surgery, which is curative and incurs a low risk of local relapse.

[Megalencephalic leukoencephalopathy with subcortical cysts: report of 4 new cases]. / La leucoencéphalopathie mégalencéphalique avec kystes sous-corticaux: description de 4 nouveaux cas.

Megalencephalic leukoencephalopathy with subcortical cysts or Van der Knapp disease is a rare entity that has recently been identified. It is characterized by the presence of macrocephaly, epilepsy and a slowly progressive spastic cerebellar syndrome. The culprit MLC1 gene is located on chromosome 22. MRI provides valuable data for diagnosis characterized by diffuse white matter lesions with subcortical cysts. We report four cases of megalencephalic leukoencephalopathy with subcortical cysts from two different families.

[Osteoid osteoma of the talus and simple bone cyst of the homolateral calcaneus. A rare association]. / Ostéome ostéoïde du talus et kyste osseux essentiel du calcanéus homolatéral. Une association rare.

Osteoid osteoma and simple bone cyst are readily observed in long bones, but are much less common in the short bones of the foot. The association of these two tumors in the same foot is exceptional. We report the case of a 15-year-old girl who presented an osteoid osteoma of the talus and a simple bone cyst of the calcaneus of the left foot. The patient complained of pain in the rear foot for four months which worsened at night and was of the inflammatory type. The physical examination was normal. Standard x-rays revealed a simple bone cyst in the calcaneus which could not explain the nighttime inflammatory pain. Scintigraphy and computed tomography of the left foot revealed an osteoid oseoma of the talus. Biopsy total resection of the osteoid osteoma with curettage and filling with cancellous bone of the simple bone cyst were performed. The patient has been free of recurrence at three years follow-up.

[Retrovesical hydatid cyst in children: report of 3 cases]. / Le kyste hydatique rétrovésical chez l'enfant: à propos de trois cas.

Retrovesical hydatid cyst is rare, even in endemic regions. From a presentation of three cases, the authors will review the clinical findings and illustrate the imaging features of this pathology and relate diagnostic and therapeutic difficulties.

[A rare aetiology of the post-partum fever: ovarian vein thrombophlebitis]. / Une cause rare de fièvre du post-partum: la thrombophlébite de la veine ovarienne.

OBJECTIVES: To clarify the contribution of the doppler and the CT in the balance aetiology of a fever of the post-partum and to connect it with a thrombophlebitis of ovarian vein. PATIENTS AND METHODS: Five patients presented there post-partum a fever with pointed abdominal painful syndrome. A doppler and a CT were performed. RESULTS: Doppler showed a hypoechoic tubular structure located forward and laterally with regard to the psoas with a flat spectre in pulsed Doppler in every case. CT confirmed the diagnosis of a thrombophlebitis of the right ovarian vein in three cases and left in two cases. Evolution after anticoagulation and an antibiotic therapy was favourable with regression of clinical signs and doppler evaluation. CONCLUSION: In front of any fever of the post-partum, it is necessary to evoke a thrombophlebitis of the vein ovarian, although it is about a rare aetiology. In spite of the superiority of the CT-scan and RP imaging for such a diagnosis, doppler is a simple and reproducible diagnostic tool for the monitoring which must be practised in first intention.